乳腺良性肿块麦默通围手术期应用尖吻蝮蛇血凝酶的药物经济学分析

Pharmacoeconomic Analysis of Haemocoagulase Agkistrodon in Perioperative Period of Breast Benign Tumor Treated with Mammotome System

目的探讨乳腺良性肿块麦默通(MMT)微创旋切术围手术期使用尖吻蝮蛇血凝酶(HCA)的药物经济学。方法 2017年1—12月胸外乳腺科240例符合纳入标准的乳腺良性肿块患者,随机分成甲、乙两组,各120例;入院后所有患者均行MMT微创旋切术,甲组术前静脉推注HCA 2 U 1次,乙组MMT术前不用HCA;两组比较平均术中出血量、术中出血率、术后出血率、治疗有效率、不良反应发生率、住院平均天数、平均药物费用和平均给药费用,最后进行成本-效果分析。结果两组平均术中出血量、术中出血率、术后出血率、不良反应发生率、住院平均天数差异均无统计学意义(P>0.05),但甲组的平均药物费用和平均给药费用均显著高于乙组(P<0.01),乙组具有成本-效果优势。结论术前使用HCA预防乳腺良性肿块MMT微创旋切术出血无明显疗效,安全性好,但经济性差。

Objective To investigate the pharmacoeconomics of haemocoagulase agkistrodon(HCA) in perioperative period of breast benign tumor treated with mammotome(MMT) system. Methods Totally, 240 patients with breast benign tumor undergoing minimally invasive MMT resection from January to December in 2017 were assigned to group A(HCA 2 U before MMT, 120 cases) and group B(HCA 0 U before MMT, 120 cases). The average intraoperative mean blood loss, incidence of intraoperative hematoma, incidence of postoperative hematoma and adverse reactions, average length of hospital stay, drug costs and administration costs were observed and the cost-effectiveness analysis was conducted. Results There were no significant differences between the two groups in the intraoperative mean blood loss and the incidence of intraoperative hematoma, the incidence of postoperative hematoma and treatment effective rate, adverse reactions and average length of hospital stay inpatient drug costs inpatient drug costs(P>0.05), but the average drug costs and administration costs significantly higher in group A than in group B(P<0.01). Group B showed cost-effectiveness advantage. Conclusion Preoperative use of HCA for the treatment of benign breast tumor with MMT minimally invasive resection to prevent bleeding is not obviously efficient, but safe and less economical.